title: [Vesiculectomy with laparoscopic partial prostatectomy in the treatment of primary adenocarcinoma of the seminal vesicle with carcinomatous transformation of the ejaculatory duct].
abstract: BACKGROUND
  Primary adenocarcinoma of the seminal vesicle is an extremely rare condition. Some cases have been described in relation to congenital seminal vesicle cysts, which is often also associated with agenesia or ipsilateral renal disgenesia. The rareness of this type of lesions makes it difficult to plan a regulated surgical approach for them, although they are often treated by simple exeresis or exenteration, depending on their stage at the beginning.
  
  
  METHODS
  We present a new surgical technique that consists of radical vesiculectomy associated with laparoscopic partial prostatectomy (total segmentary) of the central area to successfully treat primary seminal vesicle adenocarcinoma in a young man who was diagnosed through an azoospermia study.
  
  
  RESULTS
  A study of the scan (MRI) with diffusion and the transrectal biopsy of the mass allowed us to make a thorough preoperative evaluation of the case, confirming the malignity and precociousness of the lesion. The laparoscopic approach allowed us to perform a pelvic lymphadenectomy and transperitoneal exeresis, including the central prostate area and suture of the posterior face of the urethra at the height of the apex of the prostate. The wall of the seminal cyst lesion confirmed infiltrating clear cell adenocarcinoma and non-invasive adenocarcinoma in the prostate segment of the central gland in the light of the ejaculatory conduct with "in situ" growth. Thus, the surgical specimen allowed radical exeresis with negative margins, guaranteeing minimally invasive surgery with preservation of continence and erection.
  
  
  CONCLUSIONS
  We describe a new integral approach for the radical surgery of localized primary adenocarcinoma of the seminal vesicle. Despite its exceptional nature, the case allowed for a double reflection: a) The study of diffusion with MRI may suggest the diagnosis of malignity in this type of lesions; and b) Radical surgical treatment must include exeresis of the central portion of the prostate gland.
authors.affiliation: Servicio de Urología, Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Universidad Europea de Madrid, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Angulo
authors.forename: I
authors.initials: I
authors.lastname: Romero
authors.forename: P
authors.initials: P
authors.lastname: Cabrera
authors.forename: J
authors.initials: J
authors.lastname: González
authors.forename: J M
authors.initials: JM
authors.lastname: Rodríguez-Barbero
authors.forename: C
authors.initials: C
authors.lastname: Núñez-Mora
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000328:Adult; D053713:Azoospermia / Q000209:etiology; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging; D004543:Ejaculatory Ducts / Q000473:pathology / Q000601:surgery*; D005834:Genital Neoplasms, Male / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009095:Mullerian Ducts / Q000002:abnormalities; D009361:Neoplasm Invasiveness; D011468:Prostatectomy / Q000379:methods*; D012669:Seminal Vesicles / Q000000981:diagnostic imaging / Q000196:embryology / Q000473:pathology / Q000601:surgery*; D014463:Ultrasonography; D014513:Ureter / Q000002:abnormalities
chemical_list: D014408:Biomarkers, Tumor